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  • MarkS

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    My wife has tried to get insurance twice under the ACA. Both times she was told that while she qualified we didn’t make enough to get help paying the premium. Last time the premium was over $600/month. After all the bills are paid and groceries are bought we have about half that left. Hell she applied for food stamps and was denied. Before the ACA we were able to get health insurance for her but not since. We’re raising 2 grandsons and I’m disabled so she has to be home taking care of us


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    LowRiderRed

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    My wife has tried to get insurance twice under the ACA. Both times she was told that while she qualified we didn’t make enough to get help paying the premium. Last time the premium was over $600/month. After all the bills are paid and groceries are bought we have about half that left. Hell she applied for food stamps and was denied. Before the ACA we were able to get health insurance for her but not since. We’re raising 2 grandsons and I’m disabled so she has to be home taking care of us


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    Where did you get health insurance before the ACA? And how can you not make enough to qualify for help paying the premiums? Not making enough to pay the premiums is exactly what the subsidy is for isn't it?
     

    MarkS

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    Where did you get health insurance before the ACA? And how can you not make enough to qualify for help paying the premiums? Not making enough to pay the premiums is exactly what the subsidy is for isn't it?

    We were told that if we made at least 100% to 400% of the poverty level we could get help paying the premiums. Before the ACA we could shop around to find a policy we could afford now that option is gone. As for us not making enough to get help I don’t understand it either, if I made more I wouldn’t need help. The only thing we got out of her applying is an exemption from paying the fine for not having insurance. Only problem with that is I don’t have a taxable income unless an until I sell some property


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    Droshki

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    How federal poverty levels are used to determine eligibility for reduced-cost health coverage

    Income between 100% and 400% FPL: If your income is in this range, in all states you qualify for premium tax credits that lower your monthly premium for a Marketplace health insurance plan.

    Income below 138% FPL: If your income is below 138% FPL and your state has expanded Medicaid coverage, you qualify for Medicaid based only on your income.

    Income below 100% FPL: If your income falls below 100% FPL and your state hasn't expanded Medicaid coverage, you won't qualify for either income-based Medicaid or savings on a Marketplace health insurance plan. You may still qualify for Medicaid under your state's current rules.
     

    Droshki

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    In all states: You can qualify for Medicaid based on income, household size, disability, family status, and other factors. Eligibility rules differ between states.

    In states that have expanded Medicaid coverage: You can qualify based on your income alone. If your household income is below 133% of the federal poverty level, you qualify. (Because of the way this is calculated, it turns out to be 138% of the federal poverty level. A few states use a different income limit.)
     

    Droshki

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    However, Florida is one of the states that didn't expand Medicaid coverage for its citizens.


    The Affordable Care Act (ACA)*doesn’t provide subsidies for people with income below the poverty level, because the law called for them to have Medicaid instead. But in 19 states that have refused Medicaid expansion, people who aren’t eligible for Medicaid and whose income is too low for exchange subsidies are in what’s called the coverage gap. Unfortunately, they have little in the way of affordable*access to healthcare. In Florida, 467,000 people are in the coverage gap; only Texas has more people in the coverage gap.

    Source: https://www.healthinsurance.org/florida-medicaid/


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    I'm self employed, always have been. Before the ACA I would mostly just pay out of pocket as the need arose, now if I choose to pay OOP I also get fined, or I can pay monthly for coverage that doesn't cover anything. Not seeing the benefit.


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    MAXman

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    So basically MarkS, you don't make enough to qualify for aid for the ACA(probably because even with subsidies it would be too expensive),
    But since Fl never expanded Medicaid, you make too much for her to qualify for that.

    Jesus man, Ill bet she doesn't qualify for EBT because fl doesn't count the grandkids, or maybe even you, as part of the household.

    that sucks man. But thank you for sharing that anyways, a lot of people aren't comfortable talking about money(or lack of).
     

    MarkS

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    Before the ACA my wife had insurance coverage but thanks to the government it was canceled. We were making a little less back then but as my wife was wasn’t a smoker and the insurance company didn’t have a government mandate to insure every one. There were policies available that we could afford


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    Viking1204

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    So your premiums were taken out of your pay check. Does that mean your employer set up your insurance coverage? Or were you buying it on the open market and taking a payroll deduction?

    It's one of several plans offered through my employer. Before you ask, yes I compared what my employer's portion was every year and every year they paid in more too so they weren't passing the increased costs directly to me to pay less themselves. What nobody seems to understand is when you give healthcare to people who choose not to work and live off the government the people who work for a living end up paying for it.
     

    LowRiderRed

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    It's one of several plans offered through my employer. Before you ask, yes I compared what my employer's portion was every year and every year they paid in more too so they weren't passing the increased costs directly to me to pay less themselves. What nobody seems to understand is when you give healthcare to people who choose not to work and live off the government the people who work for a living end up paying for it.

    Well, that's not what I was going to ask. I was, and still am, going to ask if your employer dropped health care coverage and forced you to buy on your own.
     

    LowRiderRed

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    I'm self employed, always have been. Before the ACA I would mostly just pay out of pocket as the need arose, now if I choose to pay OOP I also get fined, or I can pay monthly for coverage that doesn't cover anything. Not seeing the benefit.


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    Isn't Alabama a state where the only available ACA coverage is from Blue Cross/Blue Shield? It's also another state where the state government refused to expand Medicaid isn't it?
     

    Droshki

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    I'm self employed, always have been. Before the ACA I would mostly just pay out of pocket as the need arose, now if I choose to pay OOP I also get fined, or I can pay monthly for coverage that doesn't cover anything. Not seeing the benefit.


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    Please forgive me, but Ive never understood this theory. Are you able to pay out of pocket for pancreatic cancer treatment, open heart surgery, or a kidney transplant?
     

    MarkS

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    MarkS that's a ridiculous situation to be in. Not expanding Medicaid has cost your family a lot.

    ACA cost my wife her insurance coverage. We don’t need Medicade we need what we had before ACA
    We own property we don’t live on and before Obama I sold a lot or two every two or three years and that covered the extras. Last year Social Security told me I qualified for extra help and I told them I didn’t, after five months they finally figured out I was right and took all five months payments out of my disability check. Luckily I had an idea they were going to catch on eventually and banked the over payments
    The government scares me every time they say we’re here to help


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    MAXman

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    Please forgive me, but Ive never understood this theory. Are you able to pay out of pocket for pancreatic cancer treatment, open heart surgery, or a kidney transplant?

    He's not talking about big ticket surgery, long term care for chronic issues or traumatic care for catastrophes. He's talking about physicals, blood work or walking to ask if that rash behind each knee that won't go away is serious.
    He's saying that he used to be able too pay the 40$ walk in fee and the 500$ blood test, but now he can't because he has to save that money back to pay the fine too the IRS.

    In all actuality Florida is screwing him by not expanding Medicaid, and making it so only the poorest percent qualified. But that doesn't mean the ACA is doing him any favors, and is costing him a fine each year(for the most rediculous reason).
    I'll bet marks actually is a proponent for the new tax plan, since it gets rid of the mandate, and if I were him I wouldn't give two cents how much it hurts homeowners in New Jersey or people who make 90000$ a year. It's already saving him money.
     

    LowRiderRed

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    ACA cost my wife her insurance coverage. We don’t need Medicade we need what we had before ACA
    We own property we don’t live on and before Obama I sold a lot or two every two or three years and that covered the extras. Last year Social Security told me I qualified for extra help and I told them I didn’t, after five months they finally figured out I was right and took all five months payments out of my disability check. Luckily I had an idea they were going to catch on eventually and banked the over payments
    The government scares me every time they say we’re here to help


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    Whether you need Medicade or not is your decision. I know I would rather have that than nothing. And what insurance did you have before you lost it?
     
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    LowRiderRed

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    He's not talking about big ticket surgery, long term care for chronic issues or traumatic care for catastrophes. He's talking about physicals, blood work or walking to ask if that rash behind each knee that won't go away is serious.
    He's saying that he used to be able too pay the 40$ walk in fee and the 500$ blood test, but now he can't because he has to save that money back to pay the fine too the IRS.

    In all actuality Florida is screwing him by not expanding Medicaid, and making it so only the poorest percent qualified. But that doesn't mean the ACA is doing him any favors, and is costing him a fine each year(for the most rediculous reason).
    I'll bet marks actually is a proponent for the new tax plan, since it gets rid of the mandate, and if I were him I wouldn't give two cents how much it hurts homeowners in New Jersey or people who make 90000$ a year. It's already saving him money.

    So how did he plan to pay for the big ticket items?
     

    Droshki

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    He's not talking about big ticket surgery, long term care for chronic issues or traumatic care for catastrophes. He's talking about physicals, blood work or walking to ask if that rash behind each knee that won't go away is serious.
    He's saying that he used to be able too pay the 40$ walk in fee and the 500$ blood test, but now he can't because he has to save that money back to pay the fine too the IRS.

    In all actuality Florida is screwing him by not expanding Medicaid, and making it so only the poorest percent qualified. But that doesn't mean the ACA is doing him any favors, and is costing him a fine each year(for the most rediculous reason).
    I'll bet marks actually is a proponent for the new tax plan, since it gets rid of the mandate, and if I were him I wouldn't give two cents how much it hurts homeowners in New Jersey or people who make 90000$ a year. It's already saving him money.

    Sure. Ok. But what happens if the blood test comes back as leukemia?
     

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